Addressing the need for an efficient and effective infrastructure for clinical research in otolaryngology-related disorders, a practice-based research network has been developed under an NIDCD infrastructure grant [DC-07-002]. Entering its fifth and final year of the grant, the CHEER Network - Creating Healthcare Excellence through Education and Research - has evolved to a peer to peer collaboration affiliated in mission to investigate questions that seek to increase and improve medical evidence for effectiveness and quality of care in the ambulatory-based practice setting. The network has been successful in not only recruiting, training and maintaining active sites, but proving the power of the network in deploying a data collection project that enrolled 1,500 patients in only 8 months. CHEER is now ready to extend the CHEER infrastructure into active conduct of research relevant to the otolaryngology community. The achievements thus far have made the network's mission to become a national resource for practice-based clinical research [www.cheerresearch.org] a tenable reality. This application ensures that the success of the CHEER network continues, ultimately becoming a sustainable resource to researchers in otolaryngology and the broader community for clinical trials, epidemiologic, comparative effectiveness and health services research needs.